Opioids: Signs, Overdose Safety, & Treatment Options
Opioids include prescription pain medicines (like oxycodone, hydrocodone, and morphine) and street opioids (like heroin). They can relieve pain, but regular use can lead to dependence and overdose risk.
Our website is for information only. We help you understand your options and prepare for conversations with licensed providers, but we do not diagnose, treat, or guarantee outcomes.
Fast Facts
Opioids slow breathing and can cause overdose, especially when mixed with alcohol or benzodiazepines.
Street supplies and counterfeit pills may contain fentanyl, which is very strong.
Naloxone can reverse an opioid overdose if given in time.
Treatment often includes medications (when appropriate) plus therapy and skills support.
Signs Opioids May Be a Problem
Treatment and support is matched to how much cannabis is affecting your life, your safety, and what you have in place at home. Some people start with lighter support; others need more structure at first and then step down.
Physical Signs
Pinpoint pupils, drowsiness, slowed breathing, constipation, nausea, itching, low energy, or needing more to feel the same effect
Behavioral Signs
Using more or longer than planned, strong cravings, spending a lot of time getting, using, or recovering, missing work or school, or secrecy about pills or powder
Mental/Emotional Signs
Mood swings, anxiety between doses, low mood, irritability, or pulling away from friends or family
Overdose Safety (Emergency)
Call your local emergency number now if someone:
- Is very hard to wake or unresponsive
- Has very slow, irregular, or stopped breathing
- Has blue or gray lips or skin, or very small “pinpoint” pupils
- Has a weak pulse, or looks pale and clammy
In case of an emergency, act quickly:
- Call emergency services and give the exact location.
- Give naloxone if you have it; repeat per instructions if no response.
- Provide rescue breathing or CPR if trained.
- Stay with the person until help arrives.
Mixing & Counterfeit Pills
Risk rises when opioids are mixed with alcohol, benzodiazepines (e.g., Xanax®, Klonopin®), sleep medications, or other depressants. This can involve slow or stopped breathing. Counterfeit pills may look real but contain unknown amounts of fentanyl. Treat any non-prescribed pill or powder as high risk.
Withdrawal Basics
Stopping after regular use can cause:
- Body aches and chills
- Restlessness and sweating
- Runny nose and stomach upset
- Poor sleep and strong cravings
Withdrawal is usually not life-threatening but can be intense and may lead to return to use. A clinician can help you start safely and reduce discomfort.
Treatment Options
Treatment for opioid use is personalized to your needs, safety, and goals. Many people start with more intensive support and gradually step down to less structured care.
Detox (When Necessary)
Detox provides medical supervision as you stop or reduce opioid use. Staff monitor withdrawal symptoms, offer medications when needed, and keep you safe and comfortable. Most people transition directly into ongoing treatment afterward.
Inpatient/Residential
Inpatient treatment means staying at a facility full-time. This is recommended when overdose risk is high, multiple substances are involved, or home isn’t a safe place to recover. You receive 24/7 structure, therapy, and medical support.
Day Program (PHP)
A Partial Hospitalization Program runs most of the day, several days per week. You go home at night but spend daytime in groups, therapy, and medical check-ins. PHP can follow inpatient care or be a start when you need support without overnight stays.
Intensive Outpatient Program (IOP)
IOP offers several hours of treatment multiple days weekly. It provides more structure than weekly therapy while allowing time for work, school, or family. Many use IOP as a step-down from PHP or inpatient.
Outpatient
Outpatient care typically means weekly or biweekly therapy sessions, plus medication management visits when needed. You work on relapse prevention, coping skills, and daily routines while living at home.
Telehealth
Telehealth allows some appointments to happen by secure video or phone. This helps if you have transport limits, live far from a clinic, or need flexible scheduling. Your provider determines which visits can be done remotely and when in-person care is needed.
Medications for Opioid Use (When Appropriate)
A prescriber may discuss:
- Buprenorphine (with or without naloxone): May reduce cravings and withdrawal. Some clinicians use low-dose “micro-starts” to ease the first days.
- Methadone: Daily, structured dosing through certified programs; may reduce withdrawal and cravings.
- Naltrexone: An opioid blocker used only after full detox.
Medication is voluntary and works best with counseling, safety planning, and practical supports. Never start, stop, or change medication without medical guidance.
Therapies & Skills That Help
Treatment may include:
CBT and DBT skills to manage triggers, cravings, and emotions
Motivational interviewing to support goals at your pace
Relapse-prevention planning and safety planning
Family sessions (with permission)
Programs may add mindfulness, movement, and routine-building to support daily stability.
Harm-Reduction Tips
If you are not ready or able to stop:
Try not to use alone; if you must, arrange a check-in with a professional who can call for help.
Carry naloxone and learn how to use it; teach friends and family.
Avoid mixing with alcohol, benzodiazepines, or sleep medications.
Treat any non-prescribed pill or powder as high risk; start with a very small amount.
Where legal and available, consider fentanyl test strips (results are not perfect).
If someone will not wake or breathe normally, treat it as an overdose and call for help immediately.
Co-Occurring Mental Health
Anxiety, depression, PTSD, or other conditions often occur alongside opioid use. Ask for combined (dual diagnosis) care so both are treated together. This can improve safety and long-term stability.
How to Choose Opioid Recovery Program
Check for state license and accreditation
Ask about medical and psychiatric staff availability
Review safety policies and detox support
Confirm aftercare planning and insurance coverage
Choosing the right program means finding a safe, accredited place that meets your needs and supports long-term recovery. Take time to ask questions and compare options before deciding.
Insurance & Costs
Coverage depends on your plan, network, and medical needs. Programs can check benefits, but your insurer makes the final decision. Ask about self-pay or payment plans if needed.
FAQs
Are opioids the same as fentanyl?
Fentanyl is an opioid but much stronger than many others and often mixed into street drugs. See the Fentanyl page for specific risks.
Do I need detox before starting medication?
Not always. It depends on the medication and your situation. A prescriber will guide you; some people start buprenorphine with a low-dose start.
Will naloxone work on strong opioids like fentanyl?
Yes. Naloxone can reverse opioid overdoses, including fentanyl. Sometimes more than one dose is needed. Always call emergency services.
Can I work or attend school during treatment?
Many people use IOP or outpatient plus telehealth for flexibility. Ask about schedules that fit your life.
How long will I need medication?
It varies. Some people use medication for months; others longer. Decisions are made with your prescriber based on safety, progress, and goals.
Helpful Resources
In Crisis? Get Immediate Help
If you are in danger or thinking of self-harm, call 911 (or your local emergency number). In the US, dial or text 988 for the Suicide & Crisis Lifeline.